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HomeMy WebLinkAboutNCC205910_NOI Application_20210104Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 12/21/2020 10:59:47 AM (NCG01 NOI Submission) Approve by Gamble, Aana C 12/22/2020 11:51:02 AM (Review- Construction NOI 39547) • The task was assigned to Gamble, Aana C by round robin distribution 12/21/2020 11:00 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 23, 2020 5:00 PM 12/21/2020 11:00 AM Submit by Selkane, Aziza 1/4/2021 12:09:27 PM (Payment Verification for NCC205910) * Smith -Edwards, LLC • Selkane, Aziza assigned the task to Selkane, Aziza 1/4/2021 12:08 PM The task was assigned to DEMLR NCG01 Payment Team. The due date is: February 2, 2021 5:00 PM 12/22/2020 11:51 AM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting IT No an NOI that was r Yes rejected before? 1a. Project Name * The Glen at Hollybrook, Phase 1A, Lot 62 1 b. Specific Lot This field rray be used to list specifc lot nunbers. Numbers 1 c. Parcel ID List all RED associated w ith this project. Number(s) (PIN) 1783923310 2. County* Wake 3. Highway or Street 1320 S Hollybrook Rd Address* Street name only is acceptable if no address nunber assigned yet 4. City or Township* Town of Wendell 5. State * NC 6. Zip Code* 27591 7. Latitude* Enter the latitude in decinal degrees 35.7610 8. Longitude * Enter the longitude in decinal degrees (MJSTbe negative) -78.3610 If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of North Carolina. Look for the coordinates in the bottom left corner. 9. Date to Begin* 03/01/2021 Estinated Construction Project Start Rate 10. Date to End* 03/01/2022 Estinated Construction Project End Cate 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial Oassification for Development 12. Acres to be 28.00 disturbed* (including off -site borrow and waste areas) 13. Total site area 51.60 (acres) * 14. Post- 10.63 construction (Estimated) impervious area (acres) * NCC Project NCC-WAKE-2021-The Glen at Hollybrook, Phase 1A, Lot 62 Tracking ID Assigned autorratically Below you must enter waterbody information for surface waters affected by this project. Please consult DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You may enter up to 3 waterbodies if needed. 15a. Receiving Buffalo Creek (Wendell Lake) Waterbody* Narreof waterbody into which storrrwater runoff will discharge 15b. Waterbody 27-57-16-(3) Index No. * NCWaterbody Index Nunber Stormwater V No discharges will flow r Yes to additional wate rs * 16a. Is this project r Yes subject to the NC r No, not subject to NC SPCA Sediment Pollution Control Act?* B. Permittee Information Part B. ^ F2rnittee Inforrration - Legally Fbsponsible Entity and Individual Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same organization. That person must be a responsible corporate officer who owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. 1. Organization Legally Pesponsible Entity Name * Smith -Edwards, LLC It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field. Note: The organization name must match the business entity name registered with the NC Secretary of State. You can verify the registration here. 2. First Name * Fred IF Corporation, enter Faegistered Agent First %rre 3. Last Name* Smith It Corporation, enter Pbegistered Agent Last %rre 3b. Title Member 4. Permitee E-mail fjsj@fredsmithcompany.com Address* 5. Permittee (919) 422-4092 Telephone No.* 6. Permittee Mailing Street Address Address* 2505 Wendell Road Address Line 2 City Wendell Fbstal / Zip Code 27591-7475 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 2505 Wendell Road Address Line 2 City Wendell Fbstal / Zip Code 27591-7475 State / Frovince / Pegion NC Country us State / Frovince / Faegion NC Country us 8. Type of Ownership is only individual if an individual is naned in B.1. above. Ownership* Non -Government C. Site Contact Information Part C. Roject Site Contact Inforrration ........................................................................................................................................................................................................................................................................... 1. Primary Site Fred Contact - First Name * 2. Primary Site Smith Contact - Last Name * 3. Title Member 4. Site Contact E- fjsj@fredsmithcompany.com mail Address* 5. Site Contact (919) 422-4092 Telephone No.* 6. Organization Smith -Edwards, LLC Name 7. Site Contact Street Address Mailing Address* 2505 Wendell Road Address Line 2 city State / Rovince / Region Wendell NC Postal / Zip Code Country 27591-7475 us 8. Consultant Name (Optional) Jon Callahan - JAECO First and Last nacre 9. Consultant E-mail info@jaeco.com This person will be copied on all correspondence. 10. Consultant (919) 828-4428 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) fjsj@fredsmithcompany.com Default is legally responsible person e-n-ail (older NOts rray not populate) 12. Billing (For Annual Fee correspondence) Telephone (919) 422-4092 Default is legally responsible person telephone (older NOLs rray not populate) D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 12/21/2020 Approved * 2. E&SC Plan Project SEC-043766-2020 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Wake County Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a complete application. Please also upload a site map showing the overall extent of the project (for linear projects, can include the beginning point and end point coordinates in the "Notes" box below). 5. E&SC Plan The Glen - Lot Approval letter or 62_MUNICIPALWatershedManagementApproval_V... 312.85KB Grading Permit 21-2020.pdf Mast be RFfornat 6. Site Location Map Mast be R7Fforrrat (lirrit 20 KE) Glen site map.pdf 921.02KB Rease do not upload entire set of E&SC plans. 7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support the application. Include additional w aterbodies if necessary. 8. NOI Certification Glen NCG01 - signed.pdf 800.52KB Form Mast be FDFfon-rat This is an Express F No Review Project* r Yes E. Certification North Carolina General Statute 143-215.66 (1) provides that: Any person who knowingly makes anyfalse statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained under this Article or a rule implementing this Atide; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Atcle; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Amide or rules of the Commission implementing this Atcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). Under penalty of law, I certify that: 17 I am the person responsible for the construction activities of this project, for satisfying the requirements of this permit, and for any civil or criminal penalties incurred due to violations of this permit. rJ The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information. * 17 I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. * rJ If the Erosion and Sediment Control Plan approved by the delegated program is not compliant with Part II (Stormwater Pollution Prevention Plan) of the NCG010000 General Permit. I will nonetheless ensure that all conditions of Part II of the permit are met on the project at all times. * 17 I hereby request coverage under the NCG010000 General Permit and understand that coverage under this permit will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual permit. Specify if you are:* r The Legally Responsible Person named on this Notice of Intent f Authorized Responsible Person' (signing on behalf of Legally Responsible Person named in Part B) Important: The person who electronically signs this Certification above must be the same person who signs the NOI Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. Signature Type Name* Fred Smith Title Member Organization Legally Pesponsible Entity Smith -Edwards, LLC Date * 12/21 /2020 F. Tracking and COC Info NOI Tracking No. 39547 NC Reference No. NCG01-2020-5910 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC205910 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 5910 Sequential nurrber for subrrittal that is incremented by Stored Frocedure COC Year 2020 Year of date reviewed (used to assign YY digits after "NOC' in COCno.) Initial Invoice No. NCC205910-2020 Invoice Due Date 1/21/2021 Initial Fee $ 100.00 Invoice Status OPEN